Vedavyas Raksha, Saravanan Ravi, Mirunalini Gunaseelan, Gayathri Balasubramaniam
Department of Anesthesiology, SRM Medical College Hospital and Research Center, SRMIST, Kattankulathur, Tamil Nadu, India.
Local Reg Anesth. 2023 May 18;16:51-58. doi: 10.2147/LRA.S409211. eCollection 2023.
The ultrasound-guided infraclavicular brachial plexus block by triple-point injection method was aimed at blocking the three individual cords in the infraclavicular region. Recently, a single-point injection method which does not require visualization of cords to produce nerve block has been introduced. This study compared the block onset time, performance time, patient's satisfaction, and complications between the ultrasound guided triple-point injection and single-point injection methods.
This randomized controlled trial was conducted in a tertiary care hospital. Sixty patients were divided into two groups - Group S: 30 patients received single-point injection method of infraclavicular block. Group T: 30 patients received triple-point injection method of infraclavicular block. Drugs used were 0.5% ropivacaine with 8 mg dexamethasone.
The sensory onset time was significantly longer in Group S (11.13 ±1.83 min) than Group T (6.20 ±1.19min). No statistically significant difference was found between the two groups regarding mean motor onset time. The composite sensorimotor onset time was similar between the groups. The mean time to perform the block was significantly lesser in Group S (1.35 ±0.38 min) when compared to group T (3.44 ±0.61min). The patient satisfaction score, conversion to general anesthesia and complications were not significant among the two groups.
We concluded that single-point injection method had a shorter performance time and similar total onset time with less procedural complications compared with triple point injection method.
超声引导下锁骨下臂丛神经阻滞的三点注射法旨在阻滞锁骨下区域的三根独立神经束。最近,一种无需可视化神经束即可产生神经阻滞的单点注射法被引入。本研究比较了超声引导下三点注射法和单点注射法之间的阻滞起效时间、操作时间、患者满意度及并发症。
本随机对照试验在一家三级护理医院进行。60例患者分为两组——S组:30例患者接受锁骨下阻滞单点注射法。T组:30例患者接受锁骨下阻滞三点注射法。使用的药物为0.5%罗哌卡因加8mg地塞米松。
S组的感觉起效时间(11.13±1.83分钟)显著长于T组(6.20±1.19分钟)。两组之间的平均运动起效时间无统计学显著差异。两组之间的复合感觉运动起效时间相似。与T组(平均3.44±0.61分钟)相比,S组的平均阻滞操作时间显著更短(1.35±0.38分钟)。两组之间的患者满意度评分、转为全身麻醉及并发症无显著差异。
我们得出结论,与三点注射法相比,单点注射法操作时间更短,总起效时间相似,且操作并发症更少。